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Solution build on top of PEGA systems

Health Insurance Provider Data Management Solution (Case Study)

Large Fortune 500 Enterprise provider of health insurance in the United States. As of 2018, the company had approximately 40 million members in 10 states in the US.

Technology Stack

Our US partner’s customer company, caters to medical service providers, be it individuals or organizations. The Medical Service Providers find it difficult to maintain a central data of their affiliates or their partner providers.
They needed a solution that provided an efficient and seamless data system, where the affiliate partner details were updated accurately and in place.

NV followed its template 3-point approach-

The Discovery – The NV Solutioning Team with deep market insights starts interacting with the key stakeholders to understand their requirements and key priorities. In parallel, the NV tech Team interacts with the technical stakeholders to understand the core concern, so as to focus on the architecture in line with best practices.

The SoleTecture – This is a sprint phase where the Solutioning and the Architecture Team perform a series of brainstorming sessions to constantly challenge each other until they agree on a mutual standpoint solution that works best for the customer. The beauty of this exercise is that the Solutioning Team creates a Minimum Viable
Product (MVP) with wireframes to ensure that the customer has the look and feel of the solution design way before the actual development

The Show – The entire exercise of this step is to ensure that the developers and QA team commence their development efforts to build the solution that fits the customer needs, against stringent timelines.

The solution built was a Provider Data Management Solution, with UI powered by PEGA 7.2, the interface development was powered by JAVA & for Storage, it was Oracle Database Suite. It was a rule-set based solution with over 172 rules, making the entire application extremely complex for implementation.

NV’s focus was centralizing these rule sets and leveraging parts of the code with clear focus on the business need.

What client say

Excellent and dynamic team:
Customer
Senior Program

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